SUN J PARK Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****30

License Status

ACTIVE

Business

First Name

SUN

Middle

Last Name

PARK

Business Name

SUN J PARK

Original Issue Date

11/06/2019

Effective Date

03/04/2026

Expiration Date

05/31/2028

City

ELK GROVE VILLAGE

State

Zip

60007

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

03/04/2026